Kimberly Anderson, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6495 Issued in MN

Practice address

1403 Silver Lake Rd NW Ste 2
New Brighton, MN 55112-9308

Phone

(651) 895-3624

NPI assigned

Aug 3, 2016

Last updated

Jun 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornelius Counseling, LLC

  dba Wellspring Counselors

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1609114883
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1891249140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 SILVER LAKE RD NW STE 2",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551129308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 SILVER LAKE RD NW STE 2",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551129308",
            "telephone_number": "651-895-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "6495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amor Home Care Services, LLC
• Courtney M Anderson, MA, LADC
• Denika Lynn Anderson, RN
• Jordan Nicholas Anderson, MA, LADC, PSYD
• Jovanna Anderson
• Leah Marie Anderson, PTA
• Mark Eric Anderson, MA LP LMFT
• Rie Anderson
• Sarah Mae Anikpo, MS, PA-C
• Kristin Marie Antil, MA, DMIN, LPCC

• Clinical Psychologist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.